scholarly journals Epidemiological Profile and Antimicrobial Resistance Pattern of Enteric Fever in a Tertiary Care Hospital of North India – a Seven Year Ambispective Study

2018 ◽  
Vol 61 (4) ◽  
pp. 125-130 ◽  
Author(s):  
Anuradha Makkar ◽  
Shilpi Gupta ◽  
Inam Danish Khan ◽  
Rajiv Mohan Gupta ◽  
KS Rajmohan ◽  
...  
Keyword(s):  
Public Health ◽  
Enteric Fever ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Multidrug Resistant ◽  
North India ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
Drug Resistant

Introduction: Enteric-fever is a major public-health problem in developing countries emerging as multidrug-resistant, Nalidixic-acid resistant and extremely drug-resistant Salmonella (Pakistan, 2016), has intensified the use of WHO watch/reserve group antimicrobials such as azithromycin and meropenem. Methods: This ambispective-study was conducted on 782 non-repeat blood-culture isolates of S. Typhi, S. Paratyphi A and S. Paratyphi B obtained from 29,184 blood cultures received at a 1000-bedded tertiary-care hospital of North-India from 2011–2017. Identification and antibiograms were obtained by Vitek-2 compact and Kirby-Bauer’s disc diffusion with resistance to ampicillin, chloramphenicol and cotrimoxazole being labeled as multidrug-resistant. Decreased ciprofloxacin-susceptibility and ciprofloxacin-resistance were defined as MIC 0.125–0.5 and >1 μg/ml. Results: S. Typhi and S. Paratyphi A in a ratio of 3.9:1 were seen between July–September predominantly distributed between 6–45 year age group. Resistance to co-trimoxazole, chloramphenicol, ceftriaxone and azithromycin was 6.1%, 13.8%, 16.1 and 5.78% respectively. Multidrug-resistant S. typhi and S. paratyphi A were 2.73% and 1.91% respectively. Conclusion: Enteric-fever is a major public-health problem in India. Emergence of multidrug-resistant, Nalidixic-acid resistant and extremely-drug resistant Salmonella mandates ongoing surveillance for targeted empirical therapy and containment of spread. Repeated epidemics call for water, sanitation, hygiene and vaccination strategies to sustain herd-immunity.

scholarly journals Identification of Risk Factors for Typhoid Fever in Children Admitted in a Tertiary Care Hospital

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Soma Halder ◽  
◽  
Md. Ekhlasur Rahman ◽  
Mst Mukta Sarker ◽  
Fabia Hannan Mone ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Enteric Fever ◽  
Tertiary Care Hospital ◽  
Systemic Disease ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Control Group ◽  
Major Public Health Problem ◽  
Care Hospital

Enteric fever remains a major public health problem in developing countries like Bangladesh. Improvement in the health facility, vaccination, and health-related awareness program the incidence of enteric fever among children is not decreased. The study aimed to find out the risk factors for enteric fever in hospitalized children in a tertiary care hospital. Methodology: We conducted a hospital-based case-control study to identify the risk factors in children residing in Dhaka city. We enrolled 50 enteric fever cases as a case group and 50 age-matched febrile patients as a control group. Result: Out of 50 cases, 2 patients were below one year and most of them were pre-school aged 26(52%). Univariate analysis showed that enteric fever is more who take food with the help of the mother and caregiver (OR=7.1); 95% CI= 26.7 -61.3) and never or rarely wash hands before preparing food and before feeding (OR= 5.7; 95% CI= 23.2 -52.8). Cases were eating outdoors at the mobile food vendors and consuming ice-cream regularly (OR=2.28; 95% CI=1- 39) whereas the control group also took street food but less frequently. Conclusion: Enteric fever is an exclusive food and water-borne systemic disease and one of the major public health problems in Bangladesh. Not only overcrowding, unsafe drinking water are the common risk factors but also hand washing both children and caregiver, poor food habit is the important risk factors. So, health education to children and food handlers may reduce the incidence of enteric fever in children.

scholarly journals Antimicrobial Resistance in Typhoidal Salmonellain a Tertiary Care Teaching Centre in North India

2021 ◽  
Vol 53 (1) ◽  
pp. 1-4
Author(s):  
Juhi Taneja ◽  
Keyword(s):  
Antimicrobial Resistance ◽  
Blood Culture ◽  
Enteric Fever ◽  
Clinical Decision Making ◽  
Tertiary Care ◽  
Herd Immunity ◽  
Public Health Problem ◽  
North India ◽  
Major Public Health Problem ◽  
Care Hospital

Introduction: Enteric fever continues to carry a high burden of morbidity and mortality in India. There have been reports of emergence of ceftriaxone resistant typhoidal Salmonella from Asia. Monitoring of antimicrobial resistance trends in typhoidal Salmonella is crucial to support in clinical decision making. Aim: To study the current susceptibility pattern of typhoidal salmonella isolates in our setup. Methods: This retrospective study was conducted on 144 non-repeat blood-culture isolates of S. Typhi, and S. Paratyphi A obtained from 3926 blood cultures received at 510-bedded tertiary-care hospital of North-India from 2017-2019. Identification and antibiograms were obtained by Vitek-2 compact and Kirby-Bauer’s disc diffusion with sensitivity to azithromycin, and chloramphenicol. Result:S. Typhi and S. Paratyphi A in a ratio of 5.2:1 were seen between months of June and July predominantly distributed between 1-10 years age group. S. Typhi resistance to co-trimoxazole, chloramphenicol, ceftriaxone and azithromycin was 21.4%, 25.6%, 12.3% and 28% respectively. S. Paratyphi A resistance to co-trimoxazole, chloramphenicol, ceftriaxone and azithromycin was 4.3%, 17.3%, 34.7% and 21.7% respectively. Conclusion: Enteric-fever is a major public-health problem in India. Emergence of ceftriaxone-resistant Salmonella mandates appropriate investigation of all febrile illnesses with blood culture whenever possible. Provision of safe drinking water, good sanitation, hygiene and vaccination strategies are needed to sustain herd-immunity.

scholarly journals Identification of Risk Factors for Typhoid Fever in Children Admitted in a Tertiary Care Hospital

2021 ◽  
Author(s):  
Soma Halder ◽  
Ekhlasur Rahman ◽  
Mst Mukta Sarker ◽  
Fabia Hannan Mone ◽  
Kuntal Roy ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Enteric Fever ◽  
Tertiary Care Hospital ◽  
Systemic Disease ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Control Group ◽  
Major Public Health Problem ◽  
Care Hospital

Enteric fever remains a major public health problem in developing countries like Bangladesh. Improvement in the health facility, vaccination, and health-related awareness program the incidence of enteric fever among children is not decreased. The study aimed to find out the risk factors for enteric fever in hospitalized children in a tertiary care hospital. Methodology: We conducted a hospital-based case-control study to identify the risk factors in children residing in Dhaka city. We enrolled 50 enteric fever cases as a case group and 50 age-matched febrile patients as a control group. Result: Out of 50 cases, 2 patients were below one year and most of them were pre-school aged 26(52%). Univariate analysis showed that enteric fever is more who take food with the help of the mother and caregiver (OR=7.1); 95% CI= 26.7 -61.3) and never or rarely wash hands before preparing food and before feeding (OR= 5.7; 95% CI= 23.2 -52.8). Cases were eating outdoors at the mobile food vendors and consuming ice-cream regularly (OR=2.28; 95% CI=1- 39) whereas the control group also took street food but less frequently. Conclusion: Enteric fever is an exclusive food and water-borne systemic disease and one of the major public health problems in Bangladesh. Not only overcrowding, unsafe drinking water are the common risk factors but also hand washing both children and caregiver, poor food habit is the important risk factors. So, health education to children and food handlers may reduce the incidence of enteric fever in children.

scholarly journals Clinico-Epidemiological Profile of Viral Sexually Transmitted Infections in Seropositive Patients Attending a Tertiary Care Hospital in North India

2017 ◽  
Vol 16 (4) ◽  
pp. 331-337 ◽  
Author(s):  
Shikha Chugh ◽  
Vijay Kumar Garg ◽  
Rashmi Sarkar ◽  
Kabir Sardana
Keyword(s):  
Sexually Transmitted Infections ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
Developed Countries ◽  
North India ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
Sexually Transmitted ◽  
Hiv Seropositive

Sexually transmitted diseases are a major public health problem both in developing and in developed countries, and especially with the co-synergy with HIV infection, there is an increasing need to have a proper understanding of the clinicodemographic patterns of sexually transmitted infections (STIs) for planning and implementing control strategies. Worldwide, there is an increased preponderance of viral STIs. Increasing incidence and altered clinical presentation of viral STIs in patients with HIV pose a diagnostic challenge; thereby, we studied the demographic profile of HIV-seropositive patients and compared clinical manifestations of viral STIs in HIV-seropositive patients to those in seronegative individuals. Twenty-seven HIV-seropositive patients with viral STI (herpes/molluscum/warts) and same number of age-, sex-, and STI-matched seronegative patients were studied for variability in clinical profile. There were significant differences in the demographic factors (education, income, and migration) and sexual practices (number of contacts and source of infection) in the 2 groups. Lesional symptoms, increased extent of lesions, and resistance to treatment were significantly more common in HIV-seropositive patients.

scholarly journals Clinical spectrum of enteric fever in children admitted to a tertiary care hospital

2020 ◽  
Vol 7 (7) ◽  
pp. 1530
Author(s):  
Jawad Nazir Wani ◽  
Abdus Sami Bhat ◽  
Saleem Yusuf ◽  
Umer Amin Qureshi
Keyword(s):  
Public Health ◽  
Blood Culture ◽  
Health Problem ◽  
Enteric Fever ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Clinical Spectrum ◽  
Care Hospital ◽  
Presenting Symptoms ◽  
Normal White Blood Cell

Background: Enteric fever is a common public health problem with variable clinical presentation. The aim of study was to study the clinical spectrum of enteric fever in children.Methods: This was a prospective study conducted over period of one year from January 2019 to January 2020 in the Department of Paediatrics at Govt Medical College Srinagar. It included all patients in the age group of 1-18 years who were clinically suspected to have enteric fever and had either a positive blood culture for Salmonella or a positive Widal test.Results: This study included total of 76 patients out of which 36 were males and 40 were females. The most common presenting symptoms were fever anorexia, vomiting, diarrohea, abdominal pain, headache and constipation. The most common signs were coated tongue, toxic look, hepatomegaly, splenomeagly, pallor, jaundice and abdominal distension. Complications were seen in in 8 (10.5%) patients. Myocarditis was seen in 3 patients. Encephalopathy and hepatitis was seen in 2 patients each. Pneumonia was seen in 1 patient. Majority of patients had normal white blood cell count (4000-11000/cumm). Leukopenia (<4000/cumm) was seen in 10% patients and leukocytosis (>11000/cumm) was seen in 15% patients. Thrombocytopenia was seen in 9% patients. Blood culture was positive in 36 (47.36%) patients. Salmonella typhi was seen in 33 patients whereas Salmonella paratyphi A was seen in 3 patients. All culture positive cases were sensitive to ceftriaxone, cefixime and azithromycin. Ciprofloxacin resistance was seen in 11 (14.4%) patients.Conclusions: Enteric fever is a common public health problem with fever as most common presenting symptom. Culture yield can be increased in enteric fever by drawing blood culture prior to administration of antibiotics. Ceftriaxone is highly efficacious as monotherapy in enteric fever.

scholarly journals Time series analysis of dengue cases reporting to a tertiary care hospital

2019 ◽  
Vol 6 (5) ◽  
pp. 2200
Author(s):  
Ravindra S. Kembhavi ◽  
Saurabha U. S.
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Arima Model ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
Series Analysis ◽  
The City

Background: Dengue fever is a major public health problem, the concern is high as the disease is closely related to climate change.Methods: This was a retrospective study, conducted for 1 year in a tertiary care hospital in the city of Mumbai. Data of Dengue cases and climate for the city of Mumbai between 2011 and 2015 were obtained. Data was analysed using SPSS- time series analysis and forecasting model.Results: 33% cases belonged to the 21-30 years, proportion of men affected were more than women. A seasonal distribution of cases was observed. A strong correlation was noted between the total number of cases reported and (a) mean monthly rainfall and (b) number of days of rainfall. ARIMA model was used for forecasting.Conclusions: The trend analysis along with forecasting model helps in being prepared for the year ahead. 

scholarly journals Prevalence of Vitamin D Deficiency among Adult Patients in A Tertiary Care Hospital

2019 ◽  
Vol 57 (218) ◽  
Author(s):  
Chandra Kala Rai ◽  
Biju Shrestha ◽  
Jyotshna Sapkota ◽  
Jay Kumar Das
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Binary Data ◽  
Tertiary Care Hospital ◽  
Musculoskeletal Diseases ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Point Estimate ◽  
Major Public Health Problem ◽  
Care Hospital

Introduction: The deficiency of vitamin D is major public health problem worldwide. It is deficiency of vitamin D level when blood serum which is below 30ng/ml. The deficiency is associated with various musculoskeletal diseases and autoimmune diseases. The early detection of deficiency plays important role to prevent those diseases. The aim of the study is to find the prevalence of vitamin D deficiency among adult population in a tertiary care hospital. Methods: This descriptive cross-sectional study was conducted in tertiary care hospital, from 1st August 2017 to 31st December 2018 after ethical clearance from institutional review committee with registration number 02082017. Simple random sampling was done. Data was collected and entered in statistical package for social sciences. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of total patients, vitamin D deficiency was found among 283 (73.6%) patients at 95% of CI (68.6-78.6). Out of total female patients, 202 (52.61%) were deficient and out of total male patients, 81 (21.08%) were deficient. The mean age±SD of patients was 41.45±16.016 years. Conclusions: The prevalence of vitamin D deficiency was high compared to previous studies. Vitamin D deficiency was found to be higher in females than males.

scholarly journals Assessment of clinical profile, antibiotic sensitivity and prescription pattern in blood culture positive enteric fever among pediatric and adult patients admitted in a tertiary care hospital: a prospective study

2019 ◽  
Vol 7 (9) ◽  
pp. 3270
Author(s):  
Swapnil Gautam ◽  
Suraj Purushothaman ◽  
Kinjal P. Patel ◽  
Ajay P. Sankhe ◽  
Madhuri R. Mahadik
Keyword(s):  
Blood Culture ◽  
Prospective Study ◽  
Enteric Fever ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Multidrug Resistant ◽  
Blood Cultures ◽  
Care Hospital ◽  
Prescription Pattern

Background: Asterion Introduction: Enteric fever is a major concern in developing country. It is predominantly caused by serovars typhi and paratyphi of Salmonella enterica. Recently, an upsurge in antimicrobial resistant strains has worsened the management of enteric fever. So, aim of present study is to evaluate the clinical profile, antibiotic sensitivity and prescription pattern in blood culture proven cases of enteric fever in pediatric and adult patients.Methods: Single centre, prospective study was conducted at a tertiary care hospital. Demographic and clinical details of blood culture proven enteric fever admitted in hospital were collected over the period from August 2016 to November 2018.Results: Total 58 blood cultures grew Salmonella spp. , amongst them 84.48 % had growth of Salmonella typhi. Blood culture was sent after a mean period of 9 days and 10 days of fever in pediatric and adult patients respectively. All isolates of S. paratyphi A were pansusceptible, whereas 36.73 % isolates of S. typhi were multidrug resistant and nalidixic acid resistant. 68.97% patients received antibiotics before admission. The difference between mean time to defervescence in patients who received ceftriaxone and those who received more than one antibiotic was not statistically significant. (P value 0.87)Conclusion: Blood cultures are the important diagnostic tool to identify multidrug resistant Salmonellae. Study showed that combination therapy was not statistically superior and awareness of local antimicrobial susceptibility pattern significantly helps for better management of the patients.

scholarly journals A clinico-epidemiological study of cutaneous changes in chronic kidney disease

2016 ◽  
Vol 2 (4) ◽  
pp. 103
Author(s):  
Chirag Maheshwari ◽  
Ajay Kumar ◽  
Sanjeev Gupta
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Tertiary Care ◽  
Public Health Problem ◽  
North India ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
Urban Background ◽  
Cutaneous Manifestations

<p class="abstract"><strong>Background:</strong> Chronic kidney disease (CKD) has emerged as a major public health problem in South Asia. This is attributable to the increase in prevalence of co-morbidities particularly hypertension and diabetes mellitus. Cutaneous manifestations are observed throughout the course of the disease and serve as markers of the disease and its progression. Early diagnosis and treatment is critical in halting the progression of the disease. The objective was to study the prevalence of co-morbidities as well as cutaneous changes in patients with CKD from a rural or semi-urban background in a tertiary care hospital.</p><p class="abstract"><strong>Methods:</strong> A total of 50 patients with CKD aged 18 years or above detected and managed at a tertiary care teaching hospital in North India were included in the study.<strong></strong></p><p class="abstract"><strong>Results:</strong> The age of the patients ranged from 18 to 78 years. 35 patients (70%) had a rural background while 15 patients (30%) had a semi-urban background. 37 patients (74%) had co-morbidities including hypertension, diabetes mellitus or both. 17 patients (34%) were on conservative management while 33 patients (66%) were undergoing haemodialysis. Skin changes included nephrogenic pruritus in 30 patients (60%), xerosis in 25 patients (50%), cutaneous infections and infestations in 25 patients (50%), pallor in 22 patients (44%), acquired perforating disorders in 6 patients (12%), purpura in 5 patients (10%), hyperpigmentation in 4 patients (8%) and yellow skin in 1 patient (2%). Hair changes were observed in 20 patients (40%), nail changes in 24 patients (48%) and mucosal changes in 20 patients (40%). None of the patients were found to have bullous dermatoses, calcific uraemic arteriolopathy or nephrogenic systemic fibrosis. 4 patients (8%) included in the study initially reported to dermatology OPD with a specific dermatosis and were detected to have CKD.</p><p><strong>Conclusions:</strong> The prevalence of co-morbidities including hypertension and diabetes associated with CKD may be lower in rural and semi-urban populations. Nephrogenic pruritus is the most distressing change which impairs the quality of life in these patients. Cutaneous changes may help in early detection and treatment of CKD. </p>

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